Service Animals
Knowing what is acceptable with service animals can be difficult, and even tougher to enforce.
It is not uncommon to receive questions regarding what to do if a patient brings in animals to your dental or medical practice. We have received questions like, “A patient just brought in four dogs with her to her appointment. What do I do?” Or another favorite, “A patient brought in his giant blue parrot for his cleaning. Is this ok?”
Knowing what is acceptable and what is not can be difficult, and even tougher to enforce. When it comes to service animals in health care settings, some clarity on the issue would be very beneficial.
What is a service animal?
Under the Americans with Disabilities Act, a service animal is defined as a dog or a small horse that has been individually trained to do work or perform tasks for an individual with a disability. The task performed by the service animal must be directly related to the person's disability.
It is also important to know what can and cannot be asked when a patient walks through the door with an animal. There are certain rights and privacies that are protected under the Americans with Disabilities Act and knowing that there are only two questions that can be asked will save you from an awkward conversation of not knowing if a question asked was acceptable or intrusive. In situations where it is not obvious that the service animal is a service animal, staff may ask only two specific questions:
“Is the dog/small horse a service animal required because of a disability”
“What work or task has the dog/small horse been trained to perform?”
Staff at your practice are not allowed to request any documentation for the service animal, require that the service animal demonstrate its task, or inquire about the nature of the person's disability.
What does perform tasks mean regarding service animals?
The service animal must be trained to take a specific action when needed to assist the person with a disability. For example, a person with diabetes may have a dog that is trained to alert him when his blood sugar reaches high or low levels. A person with depression may have a dog that is trained to remind her to take her medication. Or, a person who has epilepsy may have a dog that is trained to detect the onset of a seizure and then help the person remain safe during the seizure.
Service Animal vs Emotional Support Animal
Many people in the past have gotten these two terms confused. They are not, however, synonymous. Emotional support animals have not been trained to perform a specific task and therefore do not qualify as service animals under the Americans with Disabilities Act.
Can a person bring more than one service animal into your practice?
Yes. Some people with disabilities may use more than one service animal to perform different tasks. For example, a person who has a visual disability and diabetes may use one service animal to assist with way-finding and another that is trained to alert the person of high or low blood sugar. Other people may need two service animals for the same task, such as a person who needs two dogs to assist him or her with stability when walking. Employees may ask the two permissible questions which were stated previously about each of the animals individually.
German Shepherds make me nervous, can I turn this patient away based on the breed of their service dog?
No. The ADA does not restrict the type of dog breeds that can be service animals. A service animal may not be excluded based on assumptions or stereotypes about the animal's breed or how the animal might behave. Once again, it is important to ask the permissible questions about is this a service animal and what tasks the animal has been trained to perform. It is also important to note that service animals taken into public places must be trained. A service animal that is currently being trained, does not count as service animal. Service dogs also are not required to wear a vest, ID tag, or specific safety harness.
When is it acceptable to dismiss a patient and their service animal?
The ADA does not require covered entities to modify policies, practices, or procedures if it would “fundamentally alter” the nature of the goods, services, programs, or activities provided to the public. Nor does it overrule legitimate safety requirements. If admitting service animals would fundamentally alter the nature of a service or program, service animals may be prohibited. In addition, if a service animal behaves in a way that poses a direct threat to the health or safety of others, has a history of dangerous behavior, or is not under the control of the handler, that animal may be excluded. If an animal is excluded for such reasons, staff must still offer their goods or services to the person without the animal present.
Are any other animals acceptable as service animals?
In addition to the provisions about service dogs, the Department’s revised ADA regulations have a new, separate provision about miniature horses that have been individually trained to do work or perform tasks for people with disabilities. (Miniature horses generally range in height from 24 inches to 34 inches measured to the shoulders and generally weigh between 70 and 100 pounds.) Entities covered by the ADA must modify their policies to permit miniature horses where reasonable. The regulations set out four assessment factors to assist entities in determining whether miniature horses can be accommodated in their facility. The assessment factors are (1) whether the miniature horse is housebroken; (2) whether the miniature horse is under the owner’s control; (3) whether the facility can accommodate the miniature horse’s type, size, and weight; and (4)whether the miniature horse’s presence will not compromise legitimate safety requirements necessary for safe operation of the facility.